Intracardiac extension of intravenous leiomyomatosis

A 42-year-old woman was found to have intravenous leiomyomatosis of the uterus with extension into the inferior vena cava and right atrium. Intravenous leiomyomatosis is a rare neoplastic disease characterized by invasion of venous channels by a benign smooth muscle tumor arising either from the wall of a vessel or from a uterine myoma. Intracardiac extension is often initially misdiagnosed as a right atrial myxoma and may cause death by mechanical obstruction. The diagnosis of intravenous leiomyomatosis should be considered in young women with cardiac symptoms associated with a right atrial mass who also have a pelvic mass or who have previously undergone hysterectomy because of leiomyoma uteri.     

药物基因组学科研合作网络的统计学性质

药物基因组学是一门年轻的学科领域。该领域内相关科学研究工作者之间形成的科研合作关系网络,也具有类似许多大型合作关系网络数据库所具有的无尺度网络特性,其非连通合作网络内部具有较大连通组群的聚类特性和小世界特征等相关性质。     

Maxillofacial tumors and tumor-like lesions in a Nigerian teaching hospital: an eleven year retrospective analysis

Background

This paper reviews the types, prevalence and demographic distribution of maxillofacial tumors, cysts and tumor-like lesions in a Nigerian population.

Methods

A retrospective analysis of the medical records and histological reports of patients with oral and maxillofacial tumors and cystic lesions who presented to the Maxillofacial Unit of our institution over an eleven year period was undertaken. Information on demographics, histological diagnosis and clinical presentation were obtained and analyzed. A p value of less than 0.05 was considered significant.

Results

A total o:f 146 patients, aged 5–70 years (mean 30.5± 12.9) were seen over the period of study. There were 96 males (65.8%) and 50 females (34.2%) giving a male to female ratio of almost 2:1. Benign tumors accounted for 124, 86.3% and malignant tumors (22, 13.7%). Ameloblastoma was the most prevalent benign tumor observed (53, 36.3%) while squamous cell carcinoma was the most common malignant tumor. The peak age of ameloblastoma was the fourth decade and squamous cell carcinomas the sixth and seventh decades of life. Jaw swellings were the most common presentation (98, 67.1%), followed by pain (23, 15.9). The duration of symptoms on presentation ranged from 1 to 96 months (mean 23.32 ±15.72) and this was not different for malignant or benign tumors (P=0.886).

Conclusion

Late presentation still remains the main challenging factor in the early detection and management of maxillofacial tumors in our environment. More awareness campaign is necessary, especially at the primary health care level, to educate the populace on the need for early presentation at treatment centers.     

改良第二掌背动脉皮瓣修复示中指中末节套脱伤

目的 探讨应用第二掌背动脉(second dorsal metacarpal artery,SDMA)逆行岛状皮瓣修复示、中指中末节皮肤套状撕脱伤的方法及疗效.方法 2004年5月至2010年1月,收治17例示指或中指中末节皮肤套状撕脱伤患者.采用SDMA岛状皮瓣进行修复,并缝合指背神经.皮瓣切取面积为2.5 cm×5.6 cm～5.0cm×6.5 cm,供区创面行游离植皮.结果 术后2例皮瓣远端出现张力性水泡,表皮结痂,经换药后愈合;其余皮瓣顺利存活.皮瓣及供区植皮切口均Ⅰ期愈合.术后17例获得4～27个月的随访,平均15.3个月.皮瓣质地柔软,外观饱满无臃肿.两点分辨觉为7～11 mm,平均8.6 mm.手功能按手指总主动活动度(total active movement,TAM)法评定:优8指,良7指,可2指;优良率为88.2%.结论 缝合指背神经的改良SDMA逆行岛状皮瓣,皮瓣切取面积足够覆盖示、中指中末节套状撕脱伤皮肤缺损创面,皮瓣血运可靠,手术安全,是一种较好的手术方法.

Abstract：

Objective To investigate the operative procedure and the clinical results of the modified reversed island flap based on the second dorsal metacarpal artery (SDMA) for repairing index or long finger degloving defects.Methods From May 2004 to January 2010, circumferential soft tissue defect in the middle and distal phalanx of the index or long fingers in 17 patients were repaired by the modified reversed island flaps based on SDMA.The dorsal digital nerve in the flap was coapted to the severed proper digital nerve.The area of the flaps ranged from 2.5 cm × 5.6 cm to 5.0 cm × 6.5 cm.The donor sites were closed by skin graft.Results Postoperatively blister and necrosis of the distal flap occurred in 2 cases which was cured by dressing change.All the other flaps survived uneventfully.Primary healing of the flaps and donor sites was achieved.All 17 patients were follow-up for 4 to 27 months with an average of 15.3 months.The flaps were pliable, full but not bulky.Two-point discrimination was 7 to 11 mm (mean 8.6 mm).Hand function as judged by the total active range of motion of the fingers was excellent in 8 fingers, good in 7 fingers and fair in 2 fingers.The satisfactory rate was 88.2%.Conclusion Modified SDMA reversed island flap transfer with dorsal digital nerve coaptation is an ideal procedure to repair index or long finger degloving injuries.The area of the harvested flap is large enough to cover the circumferential soft tissue defect in the middle and distal phalanx.The surgery is safe due to the reliable flap circulation.     

茶多酚对博莱霉素导致的小鼠肺纤维化模型的干预作用及其机制

目的:研究茶多酚(简称TP)对博莱霉素(bleomycin,BLM)所致肺纤维化动物模型的干预作用,并探讨其作用机制。方法:将昆明种小鼠随机分为假手术组、模型组、醋酸泼尼松组、TP(大、中、小剂量)组。经气管内1次性灌注BLM复制肺纤维化动物模型,造模后第2天起各给药组给予相应药物灌服给药,药物干预后第7,14,28天分别处死动物,观察肺系数、肺组织羟脯氨酸(HYP)、谷胱甘肽(GSH)含质量和总抗氧化能力(T-Aoc)的变化;取固定部位肺组织作病理切片观察其病理形态;免疫组织化学技术测定肺组织中α-平滑肌肌动蛋白(α-SMA)、转化生长因子β1(TGF-β1)和I型胶原(Col-I)蛋白的表达。结果:TP可显著降低肺纤维化小鼠的肺系数、肺组织中HYP的质量,显著提高肺组织的T-Aoc和GSH质量(P<0.01,P<0.05);光镜观察显示,给予TP干预的小鼠的肺泡炎程度与肺纤维化程度明显减轻(P<0.01,P<0.05);免疫组织化学结果显示TP能显著抑制肺组织中α-SMA、TGF-β1和Col-I蛋白的表达(P<0.01,P<0.05)。结论:TP对博莱霉素所致小鼠肺纤维化具有一定的干预作用,其作用机制可能与下调TGF-β1蛋白的表达和抑制肺肌成纤维细胞的活化以及下调其下游靶基因Col-I蛋白,从而抑制细胞外基质的过度生成以及增加机体的抗氧化能力有关。     

军队灾害医学救援模式SWOT分析

文章重点应用SWOT方法,对军队灾害医学救援模式进行分析,并对发展军队灾害医学救援提出了对策。